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Regarding 2), you could just make healthcare insurance mandatory. We have that in The Netherlands.
by admiun 7y ago
Regarding 2), you could just make healthcare insurance mandatory. We have that in The Netherlands.
- lotsofpulp 7y agoIt is currently mandatory in the US , however, this year, the penalty was reduced to zero. Which means it's basically not mandatory.
- dx87 7y agoWhat if someone refuses to pay? Do they get a fine that's higher than what the cost of paying for healthcare would have been?
- hocuspocus 7y agoHere in Switzerland if you don't give proof of insurance the state will pick one for you. Then if you don't pay, it's like with any other bill, you'll get into troubles really quick.
- rumanator 7y agoSounds like it would be far simpler and easier for everyone if the state provided healthcare services paid by everyone through taxes.
- hocuspocus 7y agoYes of course, but that's beyond the point. Americans cannot argue that mandatory healthcare couldn't work in a multi-payer, private system.
- rumanator 7y agoIt really depends on your definition of "work". Being forced to subscribe to a paid service is not the same as getting access to healthcare. Your examples only show that if a state resorts to authoritarian measures then it can force everyone to subscribe to a paid service.
- seanmcdirmid 7y agoAnd if you are a foreigner, you have to provide proof of insurance when you renew your residence permit at the control de habitant.
- Faark 7y agoIts send to collections. So you're only fine if you are poor enough to not have anything they can take from you. And at that point you are eligible for gov support to your healthcare bill anyway. Here in germany you can actually kind of get away with not paying for a while when not consuming. But coverage has to be continuous, so if you need insurance since you want to go to the doctor a few years down the line, you have to pay up for the entire period.
- seanmcdirmid 7y agoHospitals already charge higher rates to those without insurance because of those payers high default rate. Collections is expensive, and they might not be able to collect anything at the end, so they price that risk into the prices.
- jki275 7y agoCite? Generally people without insurance are able to negotiate significantly lower bills - or the bills simply aren’t paid at all.
- seanmcdirmid 7y agoThey can negotiate afterwards if they say they can’t pay, but that also is already built into the higher non-insured price list...
- specialist 7y agoThere's always stragglers, hold outs, conscientious objectors, cheats, freeloaders, randos, or whatever. Just think of them as "overhead". Spend a little on "enforcement", because rules are important. Call it audits, compliance, metrics, or whatever. But not more than would be saved without enforcement. Because diminishing returns. And at some tipping point, ratcheting up cost of compliance backfires, leading to more cheating. So strive for some happy equilibrium. So that the general population (taxpayers) feel the system is reasonable, if not exactly fair, and overall friction is minimized.
- Bartweiss 7y agoBefore it was stripped from the ACA, the price for not having insurance scaled with income. At the lowest end it was irrelevant because of Medicaid eligibility; above that it gradually increased from below-healthcare-price to above. So some people could still save money by opting out, but it pushed them towards the market by making the effective cost of insurance smaller. (Technically speaking, it was a tax rather than a fine. That mostly mattered for legal reasons, but it did also work that way in practice. It applied to everyone, so insured people had the obligation waived, but the people paying it weren't in violation of any law or regulation.)